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. 2017 Apr 28;7(1):44-49.
doi: 10.15256/joc.2017.7.106. eCollection 2017.

Heart failure and multimorbidity in Australian general practice

Clare J Taylor  1 , Christopher Harrison  2 , Helena Britt  2 , Graeme Miller  2 , Fd Richard Hobbs  1
Affiliations

Heart failure and multimorbidity in Australian general practice

Clare J Taylor et al. J Comorb. .

Abstract

Background: Heart failure (HF) is a serious condition that mostly affects older people. Despite the ageing population experiencing an increased prevalence of many chronic conditions, current guidelines focus on isolated management of HF.

Objective: To describe the burden of multimorbidity in patients with HF being managed in general practice in Australia.

Design: Data from the Bettering the Evaluation And Care of Health (BEACH) programme were used to determine (i) the prevalence of HF, (ii) the number of co-existing long-term conditions, and (iii) the most common disease combinations in patients with HF. The study was undertaken over fifteen, 5-week recording periods between November 2012 and March 2016.

Results: The dataset included a total of 25,790 general practitioner (GP) encounters with patients aged ≥45 years, collected by 1,445 GPs. HF had been diagnosed in 1,119 of these patients, a prevalence of 4.34% (95% confidence interval [CI] 3.99-4.68) among patients at GP encounters, and 2.08% (95% CI 1.87-2.29) when applied to the general Australian population overall. HF rarely occurred in isolation, with 99.1% of patients having at least one and 53.4% having six or more other chronic illnesses. The most common pair of comorbidities among active patients with HF was hypertension and osteoarthritis (43.4%).

Conclusion: Overall, one in every 20-25 GP encounters with patients aged ≥45 years in Australia is with a patient with HF. Multimorbidity is a typical presentation among this patient group and guidelines for general practice must take this into account.

Keywords: aged; general practice; heart failure; multimorbidity; polypharmacy.

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Conflict of interest statement

C.H. and H.B have received research funding from Abbvie Pty Ltd., AstraZeneca Pty Ltd., the Australian Government Department of Health, Novartis Pharmaceuticals Australia Pty Ltd., Sanofi-Aventis Australia Pty Ltd., and Seqirus (Australia) Pty Ltd. C.T. received grants from the Society for Academic Primary Care, the Royal College of General Practitioners, and the National Institute for Health Research during the conduct of the study. R.H. has received speaker and consultancy fees from Bayer, BMS, Novartis and Pfizer. The views expressed in this paper are those of the authors and do not necessarily reflect the views or policies of any of the funding/contributing bodies.

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